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7 Cards in this Set
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- Back
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Chloracne
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Chloracne appears as comedones and straw-colored cysts on the face. Cysts may also occur in the axillae and groin. The condition usually appears within 2 months of exposure and resolves within 4-6 months after cessation of exposure. Chloracne is associated with dry skin, conjunctivitis, scarring, peripheral neuropathy, and liver abnormalities. Chemicals that can cause chloracne include: dioxin, pentachlorophenol, PCBs, PBBs, furans, polyhalogenated naphthalenes (polychloronaphthalenes), DDT (crude trichlorobenzene), Propanil, Methazole (both tetrachloroazoxybenzenes), 1,2,3,4-Tetrachlorobenzene, and Dichlobenil.
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Contact dermatitis, allergic
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Patch testing can be useful in distinguishing between allergic and irritant contact dermatitis. The distinction is important because patients with allergic contact dermatitis may not be able to return to their jobs, e.g., a tile layer who is allergic to chromates in cement. The concentration of the allergens used in patch testing is important because concentrations that are too high will cause false positives due to an irritant effect. [Rom, p. 625-6] Most cases of work-related dermatitis are caused by irritants. For healthcare workers the major irritants are water, antiseptic soaps, and sweat from glove occlusion. [Kanerva, p. 969] Some biological enzymes (cellulase, amylase, and xylanase) cause positive results in both patch testing (classic for Type-IV allergy) and skin pricking (Type-I, IgE-mediated allergy). In these cases, the positive patch test results may reflect an IgE-mediated reaction. [Kanerva, p. 522] Both immediate and delayed (Type I and Type IV) may be seen after contact with acrylic acid, benzocaine, carrot, chlorhexidine, chlorocresol, chrysanthemum, cinnamic aldehyde, epoxy resin, garlic, latex, lettuce, nickel sulfate, potato, soybean, and textile dyes.
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Contact dermatitis, irritant
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Skin disorders comprise about 35% of occupational diseases, and the majority of these (more than 95%) are types of contact dermatitis. Statistic in the United States show that about 80% of contact dermatitis is irritant and about 20% is allergic. Statistics in European countries suggest a 50/50 split between the irritant and allergic forms. Atopic dermatitis is a predisposing factor for irritant contact dermatitis (ICD) but not for allergic contact dermatitis (ACD). Skin irritants increase workers' risks for ACD. Common causes of ICD are water, detergents, soaps, acids, alkalis, solvents, metalworking fluids, and abrasives. "Wet work" is defined by German regulations as skin exposure to liquids or wearing occlusive gloves for >2 hours/day or hand washing >20 times/day. At risk for ICD are housekeepers, construction workers, butchers, machinists, hairdressers, food processors, and medical/dental workers. Prevention of ICD includes reducing exposure by job modification, wearing appropriate protective clothing, and using bland emollients such as white petrolatum.
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Contact dermatitis, photoallergic
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Photoallergic contact dermatitis (PACD) is a type of allergic contact dermatitis. The causative agent becomes biologically active as an allergen only after it absorbs UV light. Patients experience delayed itching and vesiculation, and only sensitized individuals react. The diagnosis of PACD can be confirmed by photo-patch testing. Occupational PACD is most prevalent among pharmacists and pharmaceutical workers who handle sulfanilamide, promethazine, or chlorpromazine.
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Contact dermatitis, photoirritant
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After permeation into the skin, a few chemicals act as irritants upon absorption of UV light. In the occupational setting, PICD is most likely to be seen among construction or railroad workers who have handled creosote or among food preparation workers who have handled lime, celery, parsnip, or figs. After skin contact with creosote, PICD may be observed immediately after exposure to light. Workers handling the dyes eosin, methylene blue or disperse blue 35 are also at risk for PICD. [Marks, p. 201-3] "Tar smarts" is a form of photoirritant dermatitis caused by coal tar pitch derived from coal, not by asphalt derived from petroleum. Workers complain of burning of the skin starting about one hour after exposure to pitch and sunlight. Erythema and blistering may ensue. Preventive measures include wearing long-sleeve shirts, gloves, and sunscreens.
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Contact urticaria
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Contact urticaria is an effervescent swelling and erythema of the skin (wheal and flare) without scaling or other changes in the epidermis. Systemic symptoms are rarely associated with contact urticaria. High-risk occupations are food handlers, bakers, healthcare workers, pharmaceutical workers, animal handlers, gardeners, florists, woodworkers, and farmworkers.
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Oil acne
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This condition was more common in the past when workers' exposures to oil and grease were higher and oil-saturated clothing was unavoidable in some jobs. Oil acne may develop in workers in oil fields, refineries, and machine shops. "McDonald's" acne may be seen in fry cooks who work in fast food restaurants. Acne cosmetica may affect actors who use cosmetics.
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